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To test a set of research questions relating to pandemic influenza vaccination, hospitalization and mortality in people with and without T2D.METHODS:

In this population-based cohort study, we linked individual-level data from several national registers for all Norwegian residents aged 30 years or older as of January 2009. People with or without T2D at baseline (n=2,992,228) were followed until December 2013. We used Cox regression to estimate adjusted hazard ratios (aHRs).RESULTS:

Pandemic influenza hospitalization was more common in individuals with T2D (aHR=2.46, 95%CI 2.04-2.98). The mortality hazard ratio associated with hospitalization for pandemic influenza was lower in people with T2D (aHR=1.82, 95%CI 1.21-2.74) than in those without T2D (aHR=3.89, 95%CI 3.27-4.62). The same pattern was observed when restricting to 90 days mortality (aHR=3.89, 95%CI 1.25-12.06 among those with T2D and aHR=10.79, 95%CI 7.23-16.10 among those without T2D). The rate of hospitalization for pandemic influenza was 78% lower in those vaccinated compared to non-vaccinated among people with T2D (aHR=0.22, 95% CI 0.11-0.39), while the corresponding estimate for those without T2D was 59% lower (aHR=0.41, 95%CI 0.33-0.52). Mortality was 25% lower in those vaccinated compared to non-vaccinated among people with T2D (aHR=0.75, 95% CI 0.73-0.77), while the corresponding estimate for those without T2D was 9% (aHR=0.91, 95%CI 0.90-0.92).CONCLUSIONS: